Abstract The International immunosuppression Transplant Skin Cancer Collaborative (ITSCCC) hosts a unique biennial scientific retreat that brings together expert clinicians and investigators from around the world whom are dedicated to caring for immunosuppressed patients with aggressive skin cancers that impact function and survival.[1-3] The population at risk in the United States includes over 300,000 patients with solid organ transplants, 200,000 with hematologic malignancies and 1.1 million who have been exposed to human immunodeficiency (HIV) virus.[4] The numbers of vulnerable will grow with 35,000 transplants expected along with 80,000 new lymphoma diagnoses expected in 2020. The ITSCC Biennial Scientific Retreat draws experts from diverse fields including dermatology, micrographic surgery and dermatologic oncology, transplant surgery, nephrology, hepatology, cardiology, radiation oncology, medical oncology, oncologic surgery, otolaryngology and plastic surgery in a rural retreat center facilitating free and rapid exchange of information. The unique environment, absent conventional silos, allows for design of robust trials, development of evidence-based guidelines and creates the opportunity to advance the state of the art of care for immune suppressed patients with aggressive skin cancer. ITSCC will advance research and clinical care through 3 specific aims: (1) Facilitate collaboration in integration of basic and clinical research to improve the quality of care of immune suppressed patients with aggressive skin cancer; (2) Develop novel and more effective means to educate patients, scientists, primary care doctors and specialist physicians on the unique needs and clinical care issues in immune suppressed patients with aggressive skin cancer; (3) Develop and disseminate sensitive screening criteria to identify highest risk individuals at earliest time point to facilitate implementation of effective strategies to prevent aggressive skin cancer in immune suppressed patients. We will achieve these aims through combination of traditional and innovative formatting. The Retreat will include traditional sessions comprised of short presentations followed by discussion. We will also include goal-directed work group sessions dedicated to development of or revision of guidelines of care and development of clinical trials and multicenter research studies. We expect 40 attendees including 10 spaces reserved for students, residents, fellows, or young investigators to insure the further growth development of the organization and achievement of long-term goals. We will disseminate our progress through publication of meeting proceedings as we have in the past and through continued presence at national meetings including the American Society for Transplantation (AST), American Academy of Dermatology (AAD), American College of Mohs Surgery (ACMS) and Society for Investigative Dermatology (SID).